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Deaf or Hard of Hearing? Duke Human Resources
705 Broad St. Box 90496
Durham, NC 27705
Phone: (919) 684-5600
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Employees' Retirement Plan Request for Benefits Estimate

(For employees on the bi-weekly payroll)

If your web browser does not support forms or you wish to submit your request by paper, please click here for the printable estimate form.

All fields are required except where noted.

Name:
 Duke Unique ID Number:
Email Address (optional):
 Daytime Phone:
 Birth Date:
Address:
City:
 State:
 Zip Code:
Please provide the following information to receive estimate(s) of your benefit options:
Anticipated date of separation from active employment (month/date/year): Estimate 1:
  Estimate 2:
  Estimate 3:

OR
Age or date that you wish to receive your benefit: Estimate 1:
  Estimate 2:
  Estimate 3:
Note: The earliest date you are eligible to receive a monthly benefit is at age 65 or at age 45 with 15 years of credited service.
If you are married, please complete the following information so that you can be shown estimates that provide payment to your spouse, in the event of your death. This is called a joint and survivor annuity.
Spouse's Birth Date:
If you are not married, but would like to designate someone to receive payments in the event of your death, please provide the following information. This is called a joint and survivor annuity.
Beneficiary's Birth Date:

If you need assistance completing this form, please contact the Human Resources Information Center (HRIC) at 684-5600 or by e-mail at benefits@duke.edu.